| NPI | 1811479793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN LYONS Owner 951-536-2213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: CA LAADC) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA LAADC) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: CA LAADC) | |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |